TELEPHONE helplines can have a savage poli­tical bite. Remember John Major's "cones hotline" which invited motorists to ring up and report what they suspected to be unnecessary roadworks?

The initiative was quietly aban­ doned three years later after it was revealed that few traffic cones were moved as a result and after call handlers began to tire of jokers ringing them up to order a 99 flake.

But at least we could make fun of the cones hotline. Not so the 111 service which the NHS introduced in April to handle out-­of­-hours calls.

It has become a dangerous embar­rassment to the Government, in some cases failing desper­ately ill patients and in others wasting NHS resources by dis­patching ambulances to people suffering from minor ailments.

We have always known that the 111 service is staffed mainly by non-­medically trained peo­ ple who are taught to identify the seriousness of a caller's symptoms by going through a basic computer program.

But yesterday a report for Channel 4's programme Dis­ patches revealed just how patchy the system is.

One call centre in Surrey, run by private company Harmoni, was left one night with just four telephone staff, none medically qualified - the sole nurse having gone home at 1am.

A manager at the centre described the service as "unsafe" at weekends.

But if you think the 111 service is better in the parts of the country where it is run directly by the NHS, forget it.

Also yesterday, NHS Direct, a department which has run a helpline since 1998, announced that it was withdrawing from running 111 services because it had decided that they were financially unsustainable.

Just what is the point of NHS Direct if it is not going to field 111 calls?

It poses as a private business with a board, a glossy annual report and executives' salaries to match - last year its chief executive Nick Chapman was paid between £150,000 and £155,000.

But it seems it doesn't want to be bothered with doing the work it was set up to do: act as a point of contact between patients and the NHS at any time of the day or night.

The tragedy is that the NHS once had excellent out-­of­-hours care. Until GPs were allowed to opt out of night-­time working a decade ago they were respons­ible for their patients' well­ being 24 hours a day.

This didn't mean that they never had any time off. During the Nineties many practices clubbed together to take it in turns to answer the telephones and, if a case sounded serious, either ask the patient to come to an emergency surgery or visit them at home.

When my children were young I remember it being an excellent service. My wife and I were never left waiting long for a doctor to call back which either resulted in our concerns for our children being calmed or, in one case, my son being admitted to hospital with an asthma attack.

Labour threw money at the service to create what it des­cribed as a "modern" NHS - taxpayers spend three times as much on the NHS as they did in 1997 - but in the important case of out-­of­-hours emergency care the service has deterio­rated badly.

A few doctors seem to have become fantastically rich from the changes, such as £230,000­a­year GP Ravi Son­ dhi who is facing a tribunal this week over allegations that he had been at his Norfolk man­ sion when he should have been providing out­of­hours care in Croydon.

But yesterday a report for Channel 4's programme Dis­ patches revealed just how patchy the system is.

But for patients the service has become pot luck.

For Reginald Foster, 64, the 111 service may even have proved fatal.

When he collapsed with abdominal pains in May his wife Barbara rang 111 and was assured an ambulance would be on its way within half an hour.

In fact it was more than three hours before it arrived by which time Mr Foster had suf­fered a cardiac arrest from which he did not recover.

Another let down by the 111 service was Jonathan Green, 54, whose wife Kim rang the service for pain relief when he was dying of prostate cancer.

Eventually she was reduced to flagging down a nurse in the street to give him an injection.

Yet at the opposite extreme, panicking 111 operators have on occasions called out ambu­lances for people who turned out to have trivial conditions - among them a hangover, a cat scratch and a cold.

You can't just blame the operators on the 111 system, the vast majority of whom I have no doubt are trying to do their job as best they can.

But when you take people with no medical qualifications, sit them in front of a computer screen with a script of pre­set questions and ask them to deal with life and death situations things are inevitably going to go wrong.

The 111 computer system depends on patients answering questions honestly; something they do not always do.

In the days when GPs were directly responsible for their patients' care out of hours they knew which ones were the hypochon­driacs who would exaggerate their symptoms.

They knew, too, which patients were likely to under­ play their symptoms because they feared wasting their doc­tor's time.

There is no way that an operator talking to a stranger over the telephone is going to have the benefit of that information.

This is the government which came to power promising no more "top­down" reorganisa­tions of the NHS.

Yet since 2010 we have had one top­down reorganisation after another. It is high time we had a bottom-­up reorganisation for a change: to put GPs back in charge of their patients' health 24 hours a day.

Prime Minister David Cameron and Health Secretary Jeremy Hunt have plenty to answer for